Irish Journal of Medical Science

, Volume 182, Issue 1, pp 17–23 | Cite as

Poisonings and clinical toxicology: a template for Ireland

Review Article

Abstract

Background

Poisons information is accessed around the clock in the British Isles from six centres of which two are in Ireland at Dublin and Belfast accompanied by consultant toxicologist advisory service. The numbers of calls in Ireland are down to about 40 per day due to easy access to online data bases. Access to Toxbase, the clinical toxicology database of the National Poisons Information Service is available to National Health Service (NHS) health professionals and to Emergency Departments and Intensive Care units in the Republic of Ireland. There are 59 Toxbase users in the Republic of Ireland and 99 % of activity originates in Emergency Departments. All United States Poison Control Centres primarily use Poisindex which is a commercial database from Thomson Reuters.

Results

Information on paracetamol, diazepam, analgesics and psycho-active compounds are the commonest queries. Data from telephone and computer accesses provide an indicator of future trends in both licit and illicit drug poisons which may direct laboratory analytical service developments. Data from National Drug-Related Deaths Index is the most accurate information on toxicological deaths in Ireland. Laboratory toxicology requirements to support emergency departments are listed.

Conclusions

Recommendations are made for a web-based open access Toxbase or equivalent; for a co-location of poisons information and laboratory clinical toxicology; for the establishment of a National Clinical Toxicology Institute for Ireland; for a list of accredited medical advisors in clinical toxicology; for multidisciplinary case conferences in complex toxicology cases for coroners; for the establishment of a national clinical toxicology referral out-patients service in Ireland.

Keywords

Poisons information Drug deaths Clinical laboratory toxicology Reform 

Notes

Conflict of interest

None.

References

  1. 1.
    National Poisons Information Service. Annual report 2010/2011. Health Protection Agency, October 2011Google Scholar
  2. 2.
    Proudfoot AT, Davidson WSM (1983) A viewpoint system for poisons information. Br Med J 286:125–127CrossRefGoogle Scholar
  3. 3.
    National Poisons Information Service. Annual Report 2009/2010 and Five Year Review. Health Protection Agency, October 2010Google Scholar
  4. 4.
    Magnani B, Kwong TC (2012) Supporting the Emergency Department. In: Magnani B (ed) Clinical Toxicology Testing, 1st edn. Cap Press, USA, pp 7–14Google Scholar
  5. 5.
    National Poisons Information Service (2002) Association of Clinical Biochemists: laboratory analyses for poisoned patients: joint position paper. Ann Clin Biochem 39:328–339CrossRefGoogle Scholar
  6. 6.
    Wu AHB, McKay C, Broussard LA et al (2003) National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: recommendations for the use of laboratory tests to support poisoned patients who present to the emergency department. Clin Chem 49:357–379PubMedCrossRefGoogle Scholar
  7. 7.
    Fabbri A, Marchesini G, Morselli-Labate AM et al (2003) Comprehensive drug screening in decision making of patients attending the emergency department for suspected drug overdose. Emerg Med J 20:25–28PubMedCrossRefGoogle Scholar
  8. 8.
    The State Laboratory. Annual Report 2010. Page 8Google Scholar
  9. 9.
    The State Laboratory. Annual Output Statement 2010Google Scholar
  10. 10.
    Health Research Board. Drug-related deaths and deaths among drug users in Ireland:2009 figures from the National Drug-related deaths index. 2011. Available at http://www.drugsand alcohol.i.e/16365
  11. 11.
    Alcohol and Drug Research Unit (2009) 2009 National Report (2008 data) to the EMCDDA by the Reitox National Focal Point. Ireland: new developments, trends and in-depth information on selected issues. Health Research Board, DublinGoogle Scholar
  12. 12.
    2009 National Report (2008 data) to the EMCDDA by the Reitox National Focal Point. United Kingdom: new developments, trends and in-depth information on selected issues. United Kingdom Focal Point on DrugsGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2012

Authors and Affiliations

  1. 1.Beaumont HospitalDublin 9Ireland
  2. 2.School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland, UK
  3. 3.Biomedical Sciences Research Institute, University of UlsterColeraineNorthern Ireland, UK

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